Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
23 Cards in this Set
- Front
- Back
Most generally classification of stroke
|
hemorrhagic vs. ischemic
|
|
Acute ischemic stroke include what 2 broad subtypes?
|
- thrombosis
- embolism |
|
What % of strokes are ischemic?
|
85%
|
|
What % of strokes are hemorrhagic?
|
15%
|
|
In general when is tPA given for stroke?
|
within 3 hours of onset for ischemic stroke
|
|
Is tPA FDA approved for use in ischemic stroke?
|
yes
|
|
7 general categories of treatment elements in acute ischemic stroke
|
- supportive care
- treatment of neurologic complications - antiplatelet therapy - glycemic control - blood pressure control - prevention of hyperthermia - thrombolytic therapy |
|
Estimated direct and indirect costs of stroke in US per year
|
$43.3 billion
|
|
3 macroscopic categories of pathophysiology of ischemic stroke
|
- extracranial embolism
- intracranial thrombosis - decreased cerebral blood flow |
|
Percentage of patients with MI that have an associated embolic stroke
|
2-3%
|
|
What time frame is the highest risk of embolic strokes as a complication of MI and what % happen during this time?
|
85% in the 1st month
|
|
General subdivision of types of thrombotic strokes
|
- large vessel (carotids)
- small vessel (circle of willis, posterior circulation) |
|
Anatomically, the most common site of thrombotic occlusion for CVA
|
cerebral artery branch points, especially in internal carotid
|
|
7 common underlying causes of thrombosis formation leading to ischemia stroke
|
- ruptured plaque
- polycythemia - sickle cell anemia - protein C deficiency - fibromuscular dysplasia of the cerebral arteries - prolonged vasoconstriction from migraine - dissection |
|
Describe the ischemic cascade of ischemic stroke
|
Loss of oxygen causes depleted O2 -> depleted ATP -> membrane depolarized -> calcium leaks in -> excitotoxicity from neurotransmitter release (self perpetuating) -> free radical formation -> gene activation that increases inflammatory cytokines
|
|
Central goal of therapy in acute ischemic stroke
|
preserve the area of oligemia in the ischemic penumbra
|
|
Main excitatory receptor involved in excitotoxicity after ischemic stroke
|
NMDA
|
|
2 major ways to preserve the area of oligemia after ischemic stroke
|
- limiting severity of injury (neuronal protection)
- reducing duration of ischemia |
|
Incidence of first time strokes in the US
|
400,000 per year
|
|
Stroke is the ___ leading cause of death in the US
|
3rd
|
|
Stroke is the ___ leading cause of disability in the US
|
1st
|
|
General gender influence on ischemic stroke
|
- more common in men
- women respond better to tPA |
|
What % of strokes occur in patients under the age of 65?
|
25%
|